| Date of birth: | Mar 13, 1952 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00021636 |
| Booking number: | 2004008826 |
| Booking date: | Dec 12, 2004 |
| Release date: | Dec 13, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 316.193 - DUI(REFUSAL) |
| Offense date: | Dec 12, 2004 |
| Bond amount: | $1,000 |